| NPI | 1568978666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARLENE BARHOO President 386-334-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |