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Organization

RAW FUSION LIVING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDAJOY ROSE (PRESIDENT)
(813) 333-2626
Entity
Organization

Contact information

Practice address
3837 NORTHDALE BLVD, SUITE 145, TAMPA, FL 33624-1841
(813) 333-2626
Mailing address
3837 NORTHDALE BLVD, SUITE 145, TAMPA, FL 33624-1841
(813) 333-2626

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/11/2012
Last updated
05/11/2012
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