| NPI | 1336791920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRYON KETCHAM CEO 415-915-9408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2021-01-20 |