| NPI | 1902431794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DAVID WARREN Owner 813-777-1263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-03-12 |
| Last Update Date | 2020-03-12 |