| NPI | 1861530875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLL RAY CARPENTER Resource Specialist Ii System Admin 813-964-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |