| NPI | 1063606028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE PAMINTUAN WAJE Owner Administrator 727-230-9946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL 692450696) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2008-07-21 |