| NPI | 1912292004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT ROSENBAUM Director 904-252-7979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY8117) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2011-06-16 |