| NPI | 1346757259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SMITH-BROWN Owner/Operator 904-651-6049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-09 |