| NPI | 1003365677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA SOUX HANCOCK Co Owner 510-497-4049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: CA OT6071) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: CA OT3300) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |