Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Voluntary or Charitable |
251V00000X | 61 | Voluntary Health or Charitable Agency[1] |
| NPI # | 1962579151 |
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| LBN Legal business name | PEDIATRIC DEVELOPMENT CENTER | ||||||||
| Authorized official | MAUREEN ATWOOD - (EXECUTIVE DIRECTOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 11/30/2006 | ||||||||
| Last updated | 08/22/2020 - About 6 years ago | ||||||||
| Identifiers |
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