| NPI | 1063116127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NUSS Owner 855-506-1906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-03-30 |