| NPI | 1215439187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGERICK GREEN Owner/ Care COO Rdination 813-297-8112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-06 |
| Last Update Date | 2018-03-06 |