| NPI | 1770725137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARIVI W NOBLEJAS PT 407-324-7204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: FL PT9967) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2009-04-01 |