| NPI | 1588937486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2023-03-12 |