| NPI | 1952798332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL HALLMON Operations Director 386-734-7571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH5223) |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2015-04-23 |