| NPI | 1316839582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVENTRICE S RIDGEWAY Executive Director 251-800-1670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |