| NPI | 1497808539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN EZELL CEO 251-232-2548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2008-06-24 |