| NPI | 1003093311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRYSTIN BULLOCK Executive / Clinical Director 407-413-9550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |