| NPI | 1558234856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISANDRA CRESPO-PEREZ Administrator 813-847-2416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-09-24 |