| NPI | 1619349347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERYLENE G. PROCTOR Owner 850-544-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 347C00000X Private Vehicle (Licence: FL p623-167-59-760-0) | |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2015-10-21 |