| NPI | 1023856358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI STONE Owner 980-613-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 385HR2065X Respite Care, Respite Care, Physical Disabilities, Child | |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2024-07-19 |