| NPI | 1700235348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN PATRICIA BASSETT Licensed Behavior Specialist 267-402-8421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PA BEH000220) |
| Enumeration Date | 2016-06-05 |
| Last Update Date | 2016-06-05 |