| NPI | 1417965252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY PHILLIPS Chief Financial Officer 173-838-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-07-17 |