| NPI | 1972121689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE PORTER Officer 352-553-9870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 372600000X Adult Companion |
| 251J00000X Nursing Care | |
| 253Z00000X In Home Supportive Care | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |