Organization
SWIFT HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS D JACKSON (CEO)
(813) 347-2802
Entity
Organization
Contact information
Practice address
2601 E LAKE AVE, TAMPA, FL 33610-7750
(813) 853-1333
Mailing address
17902 HOWSMOOR PL, LUTZ, FL 33559-3922
(813) 347-2802
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
04/25/2023
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