| NPI | 1649906314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN DESIREE RODRIGUEZ Administrator 863-471-0537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2022-07-26 |