| NPI | 1750848784 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | DONNA WATSON Owner/Manager 850-206-4845  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2019-02-26 | 
| Last Update Date | 2021-06-26 |