| NPI | 1306687108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WIDALY VIGO Director 929-273-2975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2024-08-02 |