| NPI | 1720732670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATREENA MALIK Owner 352-978-5554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |