| NPI | 1265619746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY THEODORE LEGG Managing Member 813-965-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW 5685) |
| Enumeration Date | 2008-01-27 |
| Last Update Date | 2008-08-14 |