Organization
HIDEAS LLC
Active
Other names
THE FARM
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM HOUSTON (OWNER)
(386) 438-4718
Entity
Organization
Contact information
Practice address
10828 US HIGHWAY 129, LIVE OAK, FL 32060-6789
(386) 438-4718
Mailing address
10828 US HIGHWAY 129, LIVE OAK, FL 32060-6789
(386) 438-4718
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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