| NPI | 1093594020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRARESE SANDERS Doo 330-327-2637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 251E00000X Home Health | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 251T00000X PACE Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 347C00000X Private Vehicle | |
| 385H00000X Respite Care | |
| 251B00000X Case Management | |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |