| NPI | 1215467915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINTON BRADLEY Director 501-765-2911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| 261QP2000X Clinic/Center Physical Therapy | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2022-07-21 |