| NPI | 1568678514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MOODY Clinical Director 850-957-3600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: FL 0157AD569002) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2009-07-14 |