| NPI | 1871924225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITO GASPAR Administrator 727-441-2942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: FL 6906642) |
| Additional Taxonomies | 261QA0600X Clinic/Center Adult Day Care (Licence: FL 6906642) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2013-12-11 |