| NPI | 1053066803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY STEVENS Owner 772-475-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 251E00000X Home Health | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2023-08-08 |