| NPI | 1942558150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE DENISE ROBINETTE Counselor 386-451-1025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 36 - 4354882) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |