| NPI | 1568733574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA MARTIN Owner 727-580-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 4843-6-GA) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |