| NPI | 1851848436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLIE JOHNSON Director 954-667-5616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 251S00000X |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2017-09-25 |