| NPI | 1851989552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MARCOTTE Manager 224-288-8797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-01-07 |
| Last Update Date | 2022-12-08 |