| NPI | 1700311818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LYNN GREETER Physician 904-228-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL ME 128423) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |