| NPI | 1255684981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KINA NORTHINGTON Director 267-777-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |