| NPI | 1407228836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY COLEMAN SULLIVAN Founder And CEO 774-313-0981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: CA 1-11-9321) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CA 11981) |
| 251S00000X | |
| Enumeration Date | 2015-10-25 |
| Last Update Date | 2016-09-20 |