| NPI | 1043846561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAEL KAROMBA CEO 857-200-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-03-16 |