| NPI | 1548138605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREARA JALYSE JOHNSON Manager 813-480-4786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-10-29 |
| Last Update Date | 2025-10-31 |