| NPI | 1366598484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness (Licence: FL 4037095) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-03-12 |