| NPI | 1134876089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTE HENDERSON Owner 216-413-7293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 251E00000X Home Health |
| 251S00000X | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2022-03-09 |