| NPI | 1821399890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENSIL A REYNOLDS President 772-807-1250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 151446) |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2010-11-08 |