| NPI | 1891573036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORACE MARSH Administrator 813-389-6202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |