| NPI | 1083073670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE A MOON Administrator 904-683-8666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-11 |