| NPI | 1487783379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MARTINEZ Credentialing Specialist 737-704-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-05-10 |