| NPI | 1144932526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON L SKILLERN Owner 330-356-9819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2022-12-19 |