| NPI | 1023424231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUBA PATLAKH President 267-968-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: PA 184704659) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2022-11-04 |