NPI | 1366916678 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMMY JIMMERSON CEO 855-538-7444 |
Organization Subpart ? | No |
Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
Enumeration Date | 2019-01-20 |
Last Update Date | 2019-01-20 |