| NPI | 1164809869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN BALKE President & COO 162-668-7223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2022-09-26 |