| NPI | 1730576513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON M MARTINEZ Owner 305-450-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |