| NPI | 1093956526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES KENT POWERS Md/Owner 352-376-4542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 282NC2000X General Acute Care Hospital, Children (Licence: FL ME53353) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2024-10-17 |