| NPI | 1912769332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GOYTOM HAILE BERAKI Owner 909-910-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2026-06-26 |