| NPI | 1336206424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J GARDNER CEO Administrator 727-967-2957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X (Licence: FL 688020798) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: FL 688020798) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 688020796) | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 688020798) | |
| 385H00000X Respite Care (Licence: FL 688020798) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |