| NPI | 1104470749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNDREA THOMAS-GIBSON CEO/Owner 904-339-2611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2021-01-02 |