| NPI | 1194362814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORI VONTRESE REDDICK Owner 863-427-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2021-03-09 |