| NPI | 1033904503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORY BRISSETT Program Manager 440-381-5556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-04-14 |
| Last Update Date | 2025-04-14 |