| NPI | 1275477986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITA D THOMAS Owner 667-256-3190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2026-04-15 |
| Last Update Date | 2026-04-15 |