| NPI | 1154664043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WITZA LARIONNE Owner 321-345-4177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care (Licence: FL 6906533) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: FL 232475) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2013-03-29 |