| NPI | 1780868067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORDIERES FOUNTAIN Director 850-477-3171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2007-12-22 |
| Last Update Date | 2007-12-22 |