NPI | 1295347888 |
---|---|
Entity Type | Organization |
Authorized Contact | IEISHA ALZANAM Rbt / Owner 770-375-0959 |
Organization Subpart ? | No |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2020-08-17 |
Last Update Date | 2020-08-17 |