| NPI | 1649421389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE THOMAS RAYMOND C.E.O. 813-401-6586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL SW9082) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2022-02-23 |