| NPI | 1255897088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA HOCKER Owner/Operator 352-281-6377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |