| NPI | 1811269327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA E RUSSELL President 954-854-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: FL MA0031292) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |