| NPI | 1780075952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILKIAM WILSON Ifts, Lcas A 252-312-0516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2021-01-08 |