| NPI | 1508651233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMAL JAMA Director 888-888-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2025-04-12 |
| Last Update Date | 2025-08-12 |