| NPI | 1124448410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA MICHELLE STEVENS-PELLEGRINO Owner/Officer 213-864-1870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: AZ BA116) |
| Additional Taxonomies | 251B00000X Case Management (Licence: AZ BA116) |
| 252Y00000X Early Intervention Provider Agency (Licence: AZ BA116) | |
| Enumeration Date | 2014-04-24 |
| Last Update Date | 2014-04-24 |