| NPI | 1922832062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENIA N. DAVILA ORTIZ Owner/ President 904-523-1287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP1600X Counselor Pastoral | |
| 101YP2500X Counselor Professional | |
| 103TC0700X Psychologist Clinical | |
| Enumeration Date | 2024-08-30 |
| Last Update Date | 2025-05-13 |