| NPI | 1053298752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER KYLES CEO 813-843-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |