Organization
HAWTHORNE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAHLELIA KUCHERA GODWIN (OWNER)
(352) 208-9976
Entity
Organization
Contact information
Practice address
40 BAHIA TRACE COURSE, OCALA, FL 34472
(352) 208-9976
(352) 292-4278
Mailing address
40 BAHIA TRACE COURSE, OCALA, FL 34472
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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