| NPI | 1396689105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO MARTINEZ Owner 813-520-9067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-04-14 |
| Last Update Date | 2026-04-14 |