| NPI | 1649744525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY RANDALL HOLT Bcba 931-252-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |