| NPI | 1417414053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNQUENETTE C DANIELS Owner 904-405-2631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-03-01 |