| NPI | 1740306893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR OSEI-KOFI Pharmacy Manager 813-986-0788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: FL 380100106110506) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |