| NPI | 1083317168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRESHIA MARTIN Owner/CEO 769-217-0209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-03-27 |