| NPI | 1215537436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEWIS BARTELS Managing Director 478-919-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2024-05-31 |