Organization
DHH CONNECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAILIE DUBOIS MSDE (CO-OWNER)
(248) 564-8453
Entity
Organization
Contact information
Practice address
1232 MARILYN LN, NORTH PORT, FL 34286-7689
(305) 501-0630
Mailing address
1232 MARILYN LN, NORTH PORT, FL 34286-7689
(305) 501-0630
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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