| NPI | 1578182770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA VAN DYKE Owner/Program Director 929-256-0231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2021-05-25 |