| NPI | 1457831141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY ANDREWS Owner 267-593-1473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |