| NPI | 1215467006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNE SARGENT-SUAREZ Owner 574-318-5684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2017-06-14 |