| NPI | 1023518107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIKIA MITCHELL CUNNIEN Owner 941-237-6629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2018-06-16 |