| NPI | 1285036913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONZO DIXON CEO 870-501-2042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X | |
| 222Q00000X Developmental Therapist | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 224Z00000X Occupational Therapy Assistant | |
| 224ZF0002X Occupational Therapy Assistant, Feeding, Eating & Swallowing | |
| 225100000X Physical Therapist | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225200000X Physical Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2016-07-08 |