| NPI | 1063789105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH CWIAK Managing Member 702-508-0908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NV nv20111674178) |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2011-11-26 |