| NPI | 1881177509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THOMAS LONG Executive Director 941-219-9847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2018-09-09 |
| Last Update Date | 2020-05-19 |