| NPI | 1386997526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LYNN WARREN Owner 813-850-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2013-08-28 |