| NPI | 1871143982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRISH LORRAINE PORTER Agency Owner 863-441-3919 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2020-02-26 |