| NPI | 1437762945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLE SAINT CHARLES Administrator 941-623-2677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |