| NPI | 1407557929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNY M MPULIDO Registered Behavior Technician 321-324-7478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |