| NPI | 1063895571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L NATHANIEL Owner 267-334-9523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |