| NPI | 1225662182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DASHIANNA GREEN CEO 937-346-8841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-02-28 |
| Last Update Date | 2022-08-18 |