| NPI | 1629098561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE WINTZ Administrator 904-724-6488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: FL 10609100000) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |