| NPI | 1316106909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL RANARD COOPER Chief Financial Officer 863-682-6374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 14GH01134) |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: FL 14GH01134) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |