| NPI | 1649400508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA MONIQUE GREEN Owner 252-320-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251T00000X PACE Provider Organization | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2012-10-04 |