| NPI | 1104134857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELIA VILLANUEVA OZOA Owner/Administrator 727-507-9494 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: FL 4379-6-GA) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |