| NPI | 1649021114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE MARIE FISHER Manager 727-225-4305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |