| NPI | 1306665336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGUSHA SHAGUY Director 346-383-6279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |