| NPI | 1376296202 |
|---|---|
| Doing Business As | FOREVER PLACE BEHAVIORAL LLC |
| Entity Type | Organization |
| Authorized Contact | LACHONIQUIE KIERRA EVANS Owner 567-225-4008 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-01-31 |
| Last Update Date | 2022-01-31 |