| NPI | 1073030383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY D COLEMAN Owner 412-712-6525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 310500000X Intermediate Care Facility, Mental Illness |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2022-07-21 |