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 |