| NPI | 1942606298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA JACOBS Sole Proprietor 520-275-5044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: AZ 0526) |
| Enumeration Date | 2014-11-14 |
| Last Update Date | 2014-11-14 |