| NPI | 1184703670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LYN HERRMANN Owner 602-441-5975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: AZ 2762) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2011-09-07 |