| NPI | 1215749924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL JORDAN Executive Director 321-917-9192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251K00000X Public Health or Welfare | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2025-01-21 |
| Last Update Date | 2025-01-21 |