| NPI | 1164902086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRISHA MILLER Owner 904-428-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2020-04-08 |