| NPI | 1235859869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESIENA ERUOTOR Administrator 346-754-4511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2024-08-26 |