| NPI | 1407025620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JOHNSON Executive Director 407-415-9618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC mhl-011-131) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2008-02-21 |