| NPI | 1841919867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE A DORAME Agency Administrator 120-865-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |