| NPI | 1396396552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE FLEET Executive Director 251-978-9125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 385H00000X Respite Care | |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2019-09-27 |