| NPI | 1144867359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZEKARIAS KIDANE Owner 267-992-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2023-09-01 |