| NPI | 1255197737 |
|---|---|
| Former Legal Business Name | SOUTH CENTRAL CARE PROVIDER LLC |
| Entity Type | Organization |
| Authorized Contact | DIAMOND BELLE Qwner 954-805-5488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-02-22 |