| NPI | 1265143606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WALKER Director Of Operations/Treasurer 380-212-7906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |