| NPI | 1205213832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICARMEN CARMONA President 267-349-5316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2015-05-04 |