| NPI | 1568241073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA WILDES Director Of Operations 863-634-3023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |