| NPI | 1720243587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEHINDE ADE OLAYISADE Administrator 813-420-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 692678998) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-07-22 |