| NPI | 1215723184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTRAND ADAM CHARLES Owner 941-524-0036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2025-04-17 |
| Last Update Date | 2025-04-17 |