| NPI | 1316242696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN MCCALL Owner 386-717-1808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2011-01-19 |
| Last Update Date | 2022-07-21 |