| NPI | 1336456953 |
|---|---|
| Other Name | AWS - 825 CARRICO RD |
| Entity Type | Organization |
| Authorized Contact | WILLIAM J SWISS CEO 260-744-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2014-03-13 |