| NPI | 1194933234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG HAMMOND Executive Director 800-245-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |