| NPI | 1093938102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN NATHAN Clinical Director 765-284-9573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-06-17 |