| NPI | 1659973477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ELIZABETH DESOUSA Co Founder, President 904-520-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 221700000X Art Therapist |
| 225800000X Recreation Therapist | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-17 |