| NPI | 1386279354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MCCARTHY Executive Director 857-205-6325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |