| NPI | 1265050876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE N MULONDO Administrator 774-253-7365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |