| NPI | 1508549148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNABELLE ANTHONY Administrator 667-334-0359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2023-08-10 |
| Last Update Date | 2023-08-10 |