| NPI | 1487015004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY COLEMAN Executive Director 904-535-9302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2016-03-09 |