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 |
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 |