| NPI | 1922471721 |
|---|---|
| Doing Business As | AUDREY ROACH-SLIVINSKI, LCSW |
| Entity Type | Organization |
| Authorized Contact | AUDREY ROACH-SLIVINSKI Owner 904-729-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: FL 11846) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL 11846) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: FL 11846) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: FL 11846) | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2018-03-17 |