| NPI | 1184174427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG CLARK Managing Member 941-587-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |