| NPI | 1861532640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE AMANDA PEAK Fiscal Assistant Ii 850-892-8015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: 251k00000x) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |