NPI | 1326172412 |
---|---|
Entity Type | Organization |
Authorized Contact | TIM EISSINGER CEO 017-952-5187 |
Organization Subpart ? | Yes |
Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
Enumeration Date | 2007-03-14 |
Last Update Date | 2021-02-18 |