| NPI | 1750254850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA VIRGINIA SIMPSON Executive Director 813-810-6844 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251B00000X Case Management |
| 251E00000X Home Health | |
| 251J00000X Nursing Care | |
| 251S00000X Community/Behavioral Health | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |