| NPI | 1437665627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES PERRY DUNCAN Manager 239-278-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 10001700) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |