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 Community/Behavioral Health | |
Enumeration Date | 2015-10-25 |
Last Update Date | 2016-09-20 |