| NPI | 1164191284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE ALEXIS Owner 786-390-6614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2021-09-10 |