| NPI | 1093373821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MARIE DULEY Co Owner 660-888-9373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2020-07-27 |