| NPI | 1184495020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN JASON OMOTO Executive Director 619-215-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |