| NPI | 1699348516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKORIA SMITH CEO 813-300-2846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |