| NPI | 1114229994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALISHAS C MINCEY Owner 407-928-1424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 688505596) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2010-11-29 |