| NPI | 1083736763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMANA AFTAB CEO 618-698-3479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 385H00000X Respite Care (Licence: MO 632) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-03-10 |