| NPI | 1215582226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHYKIMBERLY QUANTEZ BULLARD Owner 786-348-4771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251J00000X Nursing Care |
| 253Z00000X In Home Supportive Care | |
| 305S00000X Point of Service | |
| 311Z00000X Custodial Care Facility | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 174200000X | |
| 177F00000X Lodging | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-08-06 |
| Last Update Date | 2019-08-06 |