| NPI | 1083618649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JEAN MESMER Executive Director 727-822-4789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL R-BRO0405-100-14) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2020-08-22 |