| NPI | 1053945659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURTIS LAMONT GIBSON Owner 203-980-5479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-02-24 |