| NPI | 1467526483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONT MAZUR CFO 850-763-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: FL 010851) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |