| NPI | 1013326446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISANDRA HERNANDEZ Administrator 813-270-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL AL12543) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |