| NPI | 1073210910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH PETTUS CEO 854-432-4417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 251B00000X Case Management |
| 253Z00000X In Home Supportive Care | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2023-02-10 |
| Last Update Date | 2024-08-23 |