| NPI | 1316412323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIA LAVENDER Billing Credentialing Specialist 602-218-8679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2025-02-06 |