| NPI | 1992571012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENIA N. DAVILA ORTIZ President 904-523-1287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP1600X Counselor, Pastoral | |
| 103TC0700X Psychologist, Clinical | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2024-08-30 |