| NPI | 1013785666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANA KOLKO Administrator 833-653-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2023-12-13 |
| Last Update Date | 2024-10-09 |