| NPI | 1104718246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA WALKER Owner/ Operator 904-480-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-16 |