| NPI | 1760288138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDI LYNCH Manager 386-289-9807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251G00000X Hospice Care, Community Based |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |