| NPI | 1770156994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHLEEN KUCHTA Occupational Therapist 708-805-0173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2021-07-24 |
| Last Update Date | 2021-10-11 |