| NPI | 1437768892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINA WILLIAMS Owner 619-248-7143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2020-10-21 |