| NPI | 1194030775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENETTA T GAMMAGE Owner 623-628-4079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 252Y00000X Early Intervention Provider Agency | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2010-08-08 |
| Last Update Date | 2010-08-08 |