| NPI | 1306590260 |
|---|---|
| Doing Business As | SUPPORT INDEPENDENT LIVING |
| Entity Type | Organization |
| Authorized Contact | BRENDA F MARRIER Owner 850-259-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |