| NPI | 1821653601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLARY L. BERGER President 904-236-6776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-05-07 |
| Last Update Date | 2019-05-07 |