| NPI | 1518665843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE JOANN BUSTOS Teacher Independent Provider 646-462-8727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-02-16 |