| NPI | 1932748639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTINA PETITHOMME Administrator 786-201-4003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |