| NPI | 1730320615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASSAN EL-YOUSEF Administrator 727-373-2453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 06-52-AD-5969-01) |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |