| NPI | 1174910319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE M LOPES CEO 7182-880-0122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 011600-01) |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |