| NPI | 1366074312 |
|---|---|
| Doing Business As | AXIS SUPPORT SERVICES |
| Entity Type | Organization |
| Authorized Contact | OLABODE G LONGE Chief Executive Officer 109-298-4494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |