| NPI | 1306134184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY LORIE TOMLINSON Owner, Ed, Cm 606-425-7680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2020-06-22 |