| NPI | 1528641768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE GENAO Chief Compliance Officer 352-442-2643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 251S00000X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 273R00000X Psychiatric Unit | |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2022-06-13 |