| NPI | 1063617421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMARILIS A MOYA Itds 813-989-0435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: FL 222Q00000X) |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2008-06-16 |