Organization
BLAIR GROUP HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG ALAN BLAIR (MANAGER)
(386) 837-3125
Entity
Organization
Contact information
Practice address
211 N SPARKMAN AVE, ORANGE CITY, FL 32763-5011
(386) 775-2165
(386) 775-3165
Mailing address
211 N SPARKMAN AVE, ORANGE CITY, FL 32763-5011
(386) 775-2165
(386) 775-3165
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
678316396
FL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
678316396
FL
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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