| NPI | 1255956157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY ELAINE MCMILLAN-TINDALL Owner 772-672-1890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-08-11 |