| NPI | 1326988866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAQUANDRA JEFFERIES Owner 980-420-0626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251E00000X Home Health | |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 251B00000X Case Management | |
| 174200000X Meals | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2026-04-01 |
| Last Update Date | 2026-04-01 |