| NPI | 1477046076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESTEBAN ALFONSO RUIZ Medical Director 727-484-6169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 273R00000X Psychiatric Unit | |
| 273Y00000X Rehabilitation Unit | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |