| NPI | 1750540456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVONDA MOORE HARGROVE President 813-766-0863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: FL 320900000X) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |