| NPI | 1780137455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE FULMORE Otr/L 407-252-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: FL OT1201) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2016-07-29 |