| NPI | 1063019313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA MICHELLE NIX Fiscal Manager 256-638-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |