| NPI | 1962790295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE CICOTELLO Mental Health Consultant 702-612-3786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: CO 1552) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2013-01-09 |