| NPI | 1619629235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK MACK Director 305-992-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-01-25 |