| NPI | 1407787799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JATORIA MALONE Owner 629-629-3441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-05-26 |
| Last Update Date | 2026-05-26 |