| NPI | 1538782271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORDELL JOHN Managing Director 407-319-0838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |