| NPI | 1962757161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN A JOHNSON Therapist 904-503-2637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PMH) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2013-10-14 |