| NPI | 1962151902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUELITA DEJESUS Owner/Operator 863-440-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-12-08 |