| NPI | 1679011159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARO CEPEDA Admin 813-999-4945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 9381) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2023-11-06 |