| NPI | 1861966764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAWN LOYD Owner 813-606-0488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 385HR2050X Respite Care, Respite Care Camp | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2019-01-15 |