| NPI | 1932628245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEVON LEWIS Provider 718-496-4828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY -) |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2022-07-21 |