| NPI | 1295592368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKESHA MONEKE THOMAS Executive Director 251-550-4176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-03-04 |
| Last Update Date | 2024-03-04 |