| NPI | 1508713017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD BULLOCK Executive Director 267-808-5801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0008X Pediatrics, Neurodevelopmental Disabilities |
| Enumeration Date | 2026-03-13 |
| Last Update Date | 2026-03-13 |