| NPI | 1740478627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYNETTE LAMAR Residential Counselor 407-321-8908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: FL 323P00000X) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |