| NPI | 1346825650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIE D BARBER Adminstrator 904-707-9707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2023-03-14 |