| NPI | 1013039213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM W CONWAY Administrative Director 352-332-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL ME88464) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2011-10-07 |