| NPI | 1154193969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMLAN ARCHIE Owner 407-285-6228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-10-25 |
| Last Update Date | 2023-10-25 |