| NPI | 1437636818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA A ADESANYA CEO 904-551-0465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |