| NPI | 1780909515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FAY President 386-986-8662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2010-07-18 |