| NPI | 1669359964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JABEZ RALPH OPPONG Owner/Manager 321-662-0381 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |