| NPI | 1477812113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANKIE ESTEBAN VALLE Managing Partner 813-630-4670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 2901) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4598) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH10808) | |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2022-07-21 |