| NPI | 1346731387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUANDA SHAUNTA WHITAKER Owner 727-667-2184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-05-25 |