| NPI | 1053066845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNELISA MARISOL MACHADO Owner 855-316-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-02-20 |
| Last Update Date | 2025-12-29 |