| NPI | 1023700978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYHARA NELSON Owner 856-203-1761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-22 |