| NPI | 1720731219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER KHYRA JAMISEN NELSON Licensed Mental Health Counselor 850-766-2628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |