| NPI | 1265186159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HERMAN Owner 267-249-5721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2022-02-09 |