| NPI | 1235679499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE L FREY-DAVIS Manager 813-785-9259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9585) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2017-04-28 |