is a Developmental Disabilities in , . practices all healthcare services and medical treatments related to Developmental Disabilities. The NPI Number for is 1568512770. The last update date is .
's current location address is , , . You can contact this provider via phone number . The mailing address for is , , . To know further, please read the information below!
Provider Profile Detail
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| Address | , , |
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| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1568512770 |
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| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | |
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| City | |
| State | () |
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Provider's Primary Taxonomy Detail
| Speciality | Developmental Disabilities |
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| Taxonomy | 261Qd1600X |
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Definition: An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many ins |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 99560058 | NH | -- | |
| 99590008 | NH | -- | |
| 99560018 | NH | -- | |
| 60000008 | NH | -- | |
| 99590028 | NH | -- |
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