| NPI | 1861823452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA JUNE BAKER Medical Director 904-374-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2013-12-06 |