| NPI | 1093148306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA LASALLE HENINGBURG Director 407-518-9505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2013-08-10 |
| Last Update Date | 2018-03-17 |