| NPI | 1407562598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEMENT KWIZERA Managing Member 682-240-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2023-02-27 |