NPI | 1053470260 |
---|---|
Doing Business As | BLACKBIRD LANDING GROUP HOME |
Entity Type | Organization |
Authorized Contact | JEVON Z HICKS Director 302-377-2358 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X (Licence: DE 1518) |
Enumeration Date | 2006-12-06 |
Last Update Date | 2020-11-11 |