| NPI | 1871783001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYCLYN R SMITH-MOBLEY President/ CEO 904-327-5559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 690501396) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 690501398) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-25 |