| NPI | 1861907115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESHAWN SMITH Owner 786-368-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL 11-1248-GH) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2018-06-20 |