| NPI | 1356676787 |
|---|---|
| Other Name | 89 WINDALE DR. |
| Entity Type | Organization |
| Authorized Contact | ANITA DECKARD Administrator 731-855-0537 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-10-02 |