| NPI | 1992434302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEREN STOKES NEIL Owner 352-680-0988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2022-06-15 |