| NPI | 1114744976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL NELSON-LEWIS Owner 904-400-9864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251J00000X Nursing Care |
| 253Z00000X In Home Supportive Care | |
| 310400000X Assisted Living Facility | |
| 311Z00000X Custodial Care Facility | |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-10-19 |