| NPI | 1164799490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M BLAKESLEE President/Site Manager 407-483-0989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: FL OL-01083) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2011-12-01 |