| NPI | 1376802116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES RICHARD BLANGO Owner 252-412-0792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251T00000X PACE Provider Organization | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |