| NPI | 1174451058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA JO MCCOLLUM-DOTSON Director Of Operation 330-224-7560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2026-05-12 |
| Last Update Date | 2026-05-12 |