| NPI | 1104928407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE COLLINS Vice President Administrator 276-395-3925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2020-08-22 |