| NPI | 1730886896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY PENNELL Authorized Official 239-403-0402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-09 |