| NPI | 1306560289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JACKSON CEO 419-213-9577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |