| NPI | 1609320639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE Z HAUGABOOK Owner 772-332-2573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL CNA333101) |
| Additional Taxonomies | 251E00000X Home Health (Licence: FL CNA333101) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2016-10-20 |