| NPI | 1942791017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHANA KIRKLAND-WILLIAMS Mgr 813-787-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |