| NPI | 1093687998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN RICHARDSON Owner/Director 813-508-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-09-19 |