| NPI | 1497959605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHEL HIERHOLZER Operations Director 1419-385-0231 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2010-08-24 |