| NPI | 1184112427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMERLYN JOHNSON Owner 813-395-9950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: FL 235233) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: FL 022101700) |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 022101700) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: FL 022101700) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-05-30 |