| NPI | 1700330156 |
|---|---|
| Former Legal Business Name | JACKSON FAMILY COUNSELING |
| Entity Type | Organization |
| Authorized Contact | MICHAEL PRESTON Owner 321-480-5000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MS 2099) |
| Enumeration Date | 2016-08-14 |
| Last Update Date | 2018-11-05 |