| NPI | 1184409054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENESHIA HOLMES CEO 850-264-5509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-08-29 |