| NPI | 1376175737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIA P GRANCHAMPS Manager 321-339-6156 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-04 |