| NPI | 1356023659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEBI DAKEBO GENEMO Owner 813-842-8699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |