| NPI | 1215491618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BURTON HAYNES Director Of Finance 789-544-2920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |