| NPI | 1154118792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASAN ABDUSHAHID Chief Executive Officer 980-229-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-10-03 |