| NPI | 1497478184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ONORIODE PAULINE IGHOFOSE Member 347-480-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2023-07-18 |