| NPI | 1235599663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JACKSON SCOTT Program Director 346-691-9725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2024-09-12 |