| NPI | 1922696376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCIANA BECKLES Administrator 386-295-5638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2020-12-31 |
| Last Update Date | 2021-07-19 |