| NPI | 1295165561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN SIMMONS Owner 304-488-3742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2013-12-20 |