| NPI | 1669824686 |
|---|---|
| Other Name | BASIC.LIFE.SUPPORT.THERAPY."LLC' |
| Entity Type | Organization |
| Authorized Contact | EDWIN MAUGHN Owner 954-579-9935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL 2016001522) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL 2016001522) |
| Enumeration Date | 2016-07-02 |
| Last Update Date | 2016-07-02 |