| NPI | 1689217887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARI LU BURDEN Owner 727-657-5803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |