| NPI | 1184417529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY GOODE Owner 662-470-7232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-05-28 |
| Last Update Date | 2025-05-28 |