| NPI | 1093565590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CATHERMAN Credentialing 267-767-6851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2024-03-26 |