| NPI | 1134900384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENYA GLEATON Executive Director 980-308-3564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2023-10-12 |