| NPI | 1275756793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMA DIAZ Owner 786-942-0924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL F001) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-07-21 |