| NPI | 1467835900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEBBLES CARSON Owner/ Manager 321-396-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2018-03-17 |