| NPI | 1093985749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKIE ADAMS CEO 276-618-0759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |