| NPI | 1285008318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY HAYNES President/CEO 813-997-2397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL MH8653) |
| Additional Taxonomies | 251E00000X Home Health (Licence: VA 0001221676) |
| 251E00000X Home Health (Licence: FL RN9365072) | |
| 251J00000X Nursing Care (Licence: FL RN9365072) | |
| 251J00000X Nursing Care (Licence: VA 0001221676) | |
| 251S00000X (Licence: VA 0701006086) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL MH8653) | |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |