| NPI | 1508520792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DAVID FLETCHER President 904-759-3203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-11-02 |