| NPI | 1992238448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY WATSON CEO 813-689-4243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 018120200) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |