| NPI | 1235277237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDNES SMITH BOULANGER Counseling Services Manager 813-855-4435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: FL SW6638) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2008-07-11 |