| NPI | 1740595271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM RILLSTONE Manager 904-610-2761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: FL ARNP 1247222) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-08-09 |