| NPI | 1700403730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY CAMPI Authorized Official 352-707-1773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2020-11-25 |