| NPI | 1598610578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA DEMETRIA JOHNSON CEO 321-480-4052 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2026-03-03 |
| Last Update Date | 2026-03-03 |