| Organization Name: | POTENTIEL ILLIMITE CORP |
| NPI Number: | 1073922605 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DARYL D BOZONE (PRESIDENT) |
| Mailing Address: | 13220 Scharber Rd Dade City |
| State: | FL US |
| Postal Code: | 335258008 |
| Phone Number: | 3525885135 |
| Fax Number: | 3525885135 |
| NPI Enumeration Date: | 08/07/2014 |
| NPI Last Update Date: | 08/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW8851 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |