| NPI | 1366743361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVISHA CHEVELLE DREW Owner 1800-503-9702 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2010-11-06 |
| Last Update Date | 2010-11-06 |