| NPI | 1992075840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY M COHRS Owner 727-420-7461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |