| NPI | 1649118720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAIR-TIFFANY MCCORMICK CEO 813-701-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2026-03-23 |
| Last Update Date | 2026-03-23 |