| NPI | 1861964777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLISSA NEWTON President/CEO 772-333-0728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2018-12-18 |