| NPI | 1073286670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GBOYEGA L SALAU Program Manager 347-938-6492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |