| NPI | 1760486427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANETTE ELAINE MONJE Program Director 727-822-4789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: FL 0405-002-052) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2020-08-22 |