| NPI | 1316497241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE EVANS Sole Member 813-527-8976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL ISW11019) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |