| NPI | 1891317525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE WALLACE Owner/CEO 386-383-4562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106S00000X Behavior Technician | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |