| NPI | 1104712785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANANSIA NOBLES Managing Member 386-344-8182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-08-18 |