| NPI | 1518790179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALICIA FOSTER Executive Director 769-990-4568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-25 |