| NPI | 1285051516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKTOR SEMENOV Director 267-945-5479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: PA 315274) |
| Additional Taxonomies | 253J00000X Foster Care Agency (Licence: PA 315274) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-02-05 |