| NPI | 1700010154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA SHUMBOPOISSANT Owner 605-430-9361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: AZ DDD704011) |
| Enumeration Date | 2009-05-13 |
| Last Update Date | 2009-05-13 |