| NPI | 1033753876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANQUINITTA SCONIERS JOHNSON Director 863-934-2926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2021-01-05 |