| NPI | 1124628565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHELLE WILLIAMS Register Nurse 904-415-0913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2020-10-26 |