| NPI | 1063365013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANIQUE MICHELLE JACQUES TUCKER Managing Member 407-456-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-02-18 |
| Last Update Date | 2026-02-18 |