| NPI | 1215175708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANELL STALLWORTH Vice President 941-749-0530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL TBA) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2009-01-22 |