| NPI | 1205666096 |
|---|---|
| Former Legal Business Name | ENGLEWOOD COMMUNITY OUTREACH |
| Entity Type | Organization |
| Authorized Contact | SHANTA COPPAGE President 872-209-1298 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 373H00000X Day Training/Habilitation Specialist |
| Enumeration Date | 2024-08-06 |
| Last Update Date | 2024-08-06 |