| NPI | 1992264337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLETTA BAKER CEO 904-321-9360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251300000X Local Education Agency (LEA) |
| Additional Taxonomies | 251C00000X |
| 252Y00000X Early Intervention Provider Agency | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-03-15 |