| NPI | 1831128685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID W CHESHIRE Medical Director 904-399-5966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL 0012029) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 1732452) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |