| NPI | 1932734845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE FOLSOM Lmhc 850-331-0134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-08-07 |