Keystone Djj, LLC

NPI #1134309438 in Bristol, Florida

Provider Information

NPI Number: 1134309438
Entity Type: Organization
Organization Name: Keystone Djj, LLC
Primary Specialty: Counselor
Enumeration Date: Nov 5, 2007
Last Updated: Jun 14, 2008

Practice Location

Address: 12422 NW G T REVELL RD
City: Bristol
State: Florida
ZIP Code: 32321-3007
Phone: (850) 643-4600

Authorized Official

Name: MRS. JEANETTE JACKSON, LCSW
Title: PROGRAM DIRECTOR
Phone: (850) 643-4600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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