| NPI | 1144512468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | APRIL PARKER Billing / Enrollment Spec 850-512-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2024-05-07 |