| NPI | 1265265631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE FAYE DRAUGHN-LIGHTNER Op And Instuctor 888-340-5305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-08-21 |