| NPI | 1013902956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARA ALLYSON REYNOLDS President And CEO 813-964-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: 85-8012527472C9) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: FL 85-8012527472C-9) |
| 261Q00000X Clinic/Center (Licence: 85-8012527472C-9) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2017-03-30 |