| NPI | 1164938049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NYZIA EASTERLING Executive Director 267-444-5261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251B00000X Case Management |
| 253Z00000X In Home Supportive Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| 177F00000X Lodging | |
| 251S00000X Community/Behavioral Health | |
| 174200000X Meals | |
| 251300000X Local Education Agency (LEA) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 251V00000X Voluntary or Charitable | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| 347C00000X Private Vehicle | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 305S00000X Point of Service | |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2025-11-17 |