| NPI | 1518633569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY VICTOR TIMMEMANN Executive Director 321-253-4430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Enumeration Date | 2021-08-19 |
| Last Update Date | 2021-08-19 |