| NPI | 1164282661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYLENA RUIZ MEDINA Administrator 813-442-8480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |