NPI | 1962044602 |
---|---|
Entity Type | Organization |
Authorized Contact | HESLUNE LORRAINE BOATWRIGHT Owner 863-232-8486 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
Enumeration Date | 2019-10-15 |
Last Update Date | 2019-10-15 |