| NPI | 1942702519 |
|---|---|
| Doing Business As | DEVEREUX FLORIDA - TITUSVILLE RGC COTTAGE |
| Entity Type | Organization |
| Authorized Contact | GWEN SKINNER Executive Director 407-362-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-03-29 |