| NPI | 1184029415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAPAN B PATEL Manager 727-289-5783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL AL12564) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2014-10-29 |