| NPI | 1992979504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY G DEZURIK Administrator 479-524-5911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services (Licence: AR 251C00000X) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |