| NPI | 1902143175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT WILLIAM LAMOUREUX President 904-448-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH6823) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2019-07-19 |