| NPI | 1427568724 |
|---|---|
| Former Legal Business Name | TWO RAVENS |
| Doing Business As | WEST COAST SUPPORT SERVICES |
| Entity Type | Organization |
| Authorized Contact | VICTORIA MICHELE DEWATERS Owner 727-804-1442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2021-06-01 |