| NPI | 1558634113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTWAN LEWEY Executive Director 904-537-0599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL 100019473) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |