| NPI | 1700027406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MENDOZA President 305-971-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 691761596) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2009-03-10 |