| NPI | 1629953765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVONNE WILLIAMS Owner/Operator 904-703-7382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 311Z00000X Custodial Care Facility | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-07 |