| NPI | 1699241687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NECOLE TUNSIL Director 727-900-1170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |