| NPI | 1760313365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERCY MATTHEW SCRUGGINS Manger 904-426-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-05-25 |
| Last Update Date | 2026-05-25 |