| NPI | 1265966857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILANDER CAROL HEAD Owner 850-510-0915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2017-04-20 |