| NPI | 1013366939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVETTE GULLEY Owner 352-348-3509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL 231201) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: FL 231201) |
| 106S00000X Behavior Technician (Licence: FL 231201) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: FL 231201) | |
| 253Z00000X In Home Supportive Care (Licence: FL 231201) | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2017-01-04 |