| NPI | 1619587847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASONDRA BENNETT Director 850-557-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2020-08-03 |