| NPI | 1508794520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HINSENE SAMSON Owner 980-239-9535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2026-05-11 |
| Last Update Date | 2026-05-11 |