| NPI | 1700553633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUDAISY MOGENA Office Manager 813-909-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-08-27 |
| Last Update Date | 2024-05-06 |