| NPI | 1487400768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANAH FORBES Owner 347-574-8233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-04-30 |