| NPI | 1649249384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA FASSETT Executive Director 850-434-2638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2020-08-22 |