| NPI | 1447754478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA NICOLE POLLARD President 904-616-8146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |