| NPI | 1417435165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA SPADAFORA Practice Manager 352-678-5550 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2018-08-04 |
| Last Update Date | 2018-08-04 |