| NPI | 1689972689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL FRYE VP Of Programs 386-842-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: FL 858012627900C0) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |