| NPI | 1467836718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MCGAHAN Manager 772-349-1186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: FL 1-14-16478) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL 1-14-16478) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2016-04-01 |