| NPI | 1821244104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN A GALLAGHER Director Of Counseling 904-722-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH 4529) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |