| NPI | 1093108649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESSA SANCHEZ Human Resource 6192-750-0822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2020-08-25 |