| NPI | 1134893092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTEL JOHNSON Owner 352-877-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2022-03-15 |