| NPI | 1295265254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARVIN D. VINES President 407-495-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-07-21 |