| NPI | 1326104647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH B FICQUETTE Executive Director 813-251-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SR29AD438201) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |