| NPI | 1487422275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BISHARO IMAN Owner 320-260-6718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251E00000X Home Health |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| Enumeration Date | 2023-12-12 |
| Last Update Date | 2023-12-12 |