| NPI | 1891462321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY KASSEL Credentialing COO Rdinator 315-472-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |