| NPI | 1356844567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MICHELINE DORICENT Owner 813-465-9669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2018-03-14 |