| NPI | 1770938243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT C SLICKES Owner 813-777-8253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL MH11023) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |