| NPI | 1003695263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEON CARROLL SMITH President 980-266-2687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251C00000X |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-09-27 |
| Last Update Date | 2023-10-16 |