| NPI | 1184171753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCHARAZARD LEE GRAY Director 813-310-9346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: ND 12015) |
| Additional Taxonomies | 261QR1100X Clinic/Center, Research (Licence: ND 12015) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |