| NPI | 1790094803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH PESCE Secretary 904-605-4986 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL 092 - 495) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL 092-572) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MHL 032-384) | |
| Enumeration Date | 2010-10-07 |
| Last Update Date | 2022-12-01 |