| NPI | 1033084629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRICETTA L. MOORE Owner 813-330-5932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-10-06 |
| Last Update Date | 2025-10-06 |