| NPI | 1740247204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP STEVEN WELLS President/Chief Operating Officer 727-539-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL AL 9425) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2020-08-22 |