| NPI | 1013891456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ANIOKE Owner 469-463-4302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-31 |
| Last Update Date | 2025-07-31 |