| NPI | 1508462482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY KIMBERLY RAMIREZ Presitdent 172-036-1635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |