| NPI | 1790501146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA PATTERSON Billing Manager 904-765-0665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |