| NPI | 1295670875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TUMACHA AGHENEZA Administrator 857-237-1713 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2026-04-21 |
| Last Update Date | 2026-04-21 |