| NPI | 1023756277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLLANDA MOORE Director 321-208-3891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 261QP2000X Clinic/Center Physical Therapy | |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-05-26 |