| NPI | 1396490801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JALANEIA RENEE GUIONS Medicaid Waiver Provider 352-434-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-02-14 |
| Last Update Date | 2022-04-14 |