| NPI | 1164136776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HUGH FITZGERALD Owner 267-634-1784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-05-06 |