| NPI | 1376079459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLYNNE MENOR Caregiver 808-343-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |