| NPI | 1922105188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN GARZA Financial Officer 813-804-4192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL SR29AD803901) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL SR29AD803901) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-05-08 |