| NPI | 1023417045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCHUYLER S. SIEFKER Executive Director 904-829-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: FL MH4993) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |