| NPI | 1265045629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2023-03-04 |