| NPI | 1144705187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI STONE Co Owner 980-613-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |