| NPI | 1780428359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNESHIA MARTIN Administrator 813-467-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 347C00000X Private Vehicle | |
| 372600000X Adult Companion | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |