| NPI | 1487839304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL SORTINO Program Director 850-769-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |