| NPI | 1568178622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE WALINJOM President 443-929-9923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 106E00000X Assistant Behavior Analyst | |
| 103K00000X Behavior Analyst | |
| 106S00000X Behavior Technician | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-01-23 |