| NPI | 1154033512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAKIM ABDUL GLOVER CEO 267-881-7013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 103TM1800X Psychologist Mental Retardation & Developmental Disabilities |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 253Z00000X In Home Supportive Care | |
| 385H00000X Respite Care | |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2022-12-16 |