| NPI | 1588144802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORA LEE FLEMING Owner 904-805-2230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |