| NPI | 1508999889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 311ZA0620X Custodial Care Facility Adult Care Home (Licence: CT R-1013) | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2023-04-18 |