| NPI | 1366855587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE MICHAELS Owner 727-278-8375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 4899) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |