| NPI | 1184932956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY F SCHULTZ Executive Director 904-721-5992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 679204996) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |