| NPI | 1962063073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILLANN MICHELLE LEWIS Sole Member/Owner 917-592-2506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |