Organization
SHANTELL FOSTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANTELL FOSTER (OWNER)
(904) 753-3285
Entity
Organization
Contact information
Practice address
96159 MOUNT ZION LOOP, YULEE, FL 32097-6332
(904) 753-3285
(904) 849-7124
Mailing address
96159 MOUNT ZION LOOP, YULEE, FL 32097-6332
(904) 753-3285
(904) 849-7124
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
FL
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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