| NPI | 1568070035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD JOHNSON CEO 813-279-0984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2020-07-21 |
| Last Update Date | 2020-07-21 |