| NPI | 1144550021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA SUE HEDSTROM Owner 813-943-6335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW 9194) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2009-12-28 |