| NPI | 1831279280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANGELA PULSFUS Chief Executive Officer 904-829-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL 0455AD258200) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-02-21 |