| NPI | 1780408930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BROADNAX Administrator 904-552-9094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2024-11-14 |
| Last Update Date | 2024-11-14 |