| NPI | 1548987241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAOBA RAY MCCOY Owner 646-685-9070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 251B00000X Case Management | |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-12-27 |