| NPI | 1982781076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DUGO State Director 352-735-0588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2015-06-05 |