| NPI | 1710551726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CIERA LESHAY RICHARDSON Owner 352-875-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-14 |