| NPI | 1023485315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LYNN WARREN Owner 813-850-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2015-08-21 |