| NPI | 1346691177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIXON MWOSE CEO 574-276-9831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-06-22 |