| NPI | 1811021488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUWOLLAR MESHET MOBLEY Facility Administrator 850-948-4220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-06-20 |