| NPI | 1376695965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS HOLTEN OBANION Executive Director 813-961-1159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2011-03-15 |