| NPI | 1174414874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKENZIE HANLIN Clinical Director/Owner 239-910-8384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 225A00000X Music Therapist | |
| 225XE0001X Occupational Therapist Environmental Modification | |
| 225XE1200X Occupational Therapist Ergonomics | |
| 225XP0019X Occupational Therapist Physical Rehabilitation | |
| 225XP0200X Occupational Therapist Pediatrics | |
| 235Z00000X Speech-Language Pathologist | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 343800000X Secured Medical Transport (VAN) | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-07-10 |
| Last Update Date | 2025-07-10 |