NPI | 1164001053 |
---|---|
Entity Type | Organization |
Authorized Contact | TRINA VERNELL BOYD President 980-213-1290 |
Organization Subpart ? | No |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 251S00000X |
347C00000X Private Vehicle | |
385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2024-05-02 |