| NPI | 1104596543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R MAYMON CEO 972-882-9498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2023-03-30 |