| NPI | 1013443712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMBRIGE BEMBRY Medicaid Waiver Provider 863-845-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |