NPI | 1922604982 |
---|---|
Entity Type | Organization |
Authorized Contact | EBONY MAIA WHITAKER Owner/Provider 813-863-7570 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Enumeration Date | 2020-12-07 |
Last Update Date | 2020-12-07 |