| NPI | 1649728106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL ELOISIN Behavior Assistant 855-832-6727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 624276) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |