| NPI | 1043038557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLET ROBERTS Administrator 346-255-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-10-02 |