NPI | 1568014868 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK ANTHONY MITE O Wner 904-460-4919 |
Organization Subpart ? | No |
Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
Enumeration Date | 2019-07-16 |
Last Update Date | 2019-07-16 |