| NPI | 1932154945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER MALAVE CEO 904-605-4986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2023-06-19 |