| NPI | 1184466690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYDELIS PENA Otr/Owner 239-214-4128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2025-08-22 |