| NPI | 1104489079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN BLANCO LEZCANO Owner 786-319-0748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |