| NPI | 1912493917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LAND CEO 386-623-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| 175F00000X Naturopath | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2020-01-03 |