| NPI | 1366826596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T SANNUTO Facility Executive Director 813-605-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 1002043) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: FL 1002044) |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: FL 1002045) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 2901) | |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2025-01-30 |