| NPI | 1598726648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL HABERMEHL Billing/Claims/Managed Care Director 941-331-2530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X (Licence: FL 1423) | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-09-09 |