| NPI | 1396443883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND R GRAY Vice President For Administration 176-344-7106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2023-02-23 |