| NPI | 1487537015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GISELLE RODRIGUEZ Owner/Administrator 813-917-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-07-30 |