| NPI | 1225569858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK GULYAKO Member 347-372-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-07-31 |