| NPI | 1952707176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTI D KEEN Owner 850-522-9719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH11871) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2014-11-16 |