| NPI | 1528850898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIROA REYNOLDS Administartor 813-750-6532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2025-05-21 |
| Last Update Date | 2025-05-21 |