| NPI | 1467987701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADOOREE MICHELLE TULLAR Executive Director 769-241-5146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2022-06-05 |