Organization
HEART OF FLORIDA YOUTH RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM MARSHALL FRYE PH.D. (ADMINISTRATOR)
(352) 595-7100
Entity
Organization
Contact information
Practice address
15833 N US HIGHWAY 301, CITRA, FL 32113-3155
(352) 595-7100
(352) 595-4135
Mailing address
PO BOX 336, 15833 US 301 N, CITRA, FL 32113-0336
(352) 595-7100
(352) 595-4135
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253J00000X
Foster Care Agency
—
—
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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