| NPI | 1508356254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXWELL BOIMA SANDO Founder/CEO 563-381-0223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2018-05-17 |
| Last Update Date | 2018-08-17 |