| NPI | 1063274918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY JOYAL LLC Member, Doo 813-951-5822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| 251E00000X Home Health | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-01-26 |
| Last Update Date | 2024-01-26 |