| NPI | 1508386988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JAMES KILLINGSWORTH Director 209-968-0574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: NV 1-14-17036) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NV RBT-17-32922) |
| 385H00000X Respite Care | |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2023-02-10 |