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, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2020-02-24 |
Last Update Date | 2020-02-24 |