| NPI | 1245103035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY ROSE JORDEN-LAWAL Owner 346-309-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-09-26 |