| NPI | 1356835862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESHAE MARTIN Administrative Director 813-585-7708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0001X Internal Medicine Clinical & Laboratory Immunology |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 373H00000X Day Training/Habilitation Specialist | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2021-06-11 |