NPI | 1104590363 |
---|---|
Entity Type | Organization |
Authorized Contact | JULIETTE EKI Director 346-247-4934 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 251B00000X Case Management |
251S00000X | |
Enumeration Date | 2021-08-02 |
Last Update Date | 2023-07-03 |