| NPI | 1477244820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHILOH FLYNN CEO 917-436-8506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-05-17 |