| NPI | 1003552373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOUCHECA AUGUSTIN CEO 754-234-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-05-10 |