| NPI | 1922619741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAPORSCHE QUINTELLA HOLMES Owner 352-777-3898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |