| NPI | 1306459359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA JOY LITTLE Owner 904-469-5933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |