| NPI | 1023617255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA ALFORD Chief Operating Officer 267-997-6721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2021-06-22 |