| NPI | 1700369857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA COUNCIL Owner 904-355-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 251V00000X Voluntary or Charitable | |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2019-06-30 |