| NPI | 1306616875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CAMAROU Administrator 918-510-0114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-01-05 |
| Last Update Date | 2024-01-29 |