| NPI | 1528654746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMONE REEVES Owner 980-339-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2020-12-13 |
| Last Update Date | 2020-12-13 |