| NPI | 1366856551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASHA GOODEN Manager 305-528-2689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |