| NPI | 1033665799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN BRANDY CHENET Owner 937-580-7921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: OH RQ746261) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |