| NPI | 1376023242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANIE CONRAD Chief Of Operations 817-889-4136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2018-08-20 |