| NPI | 1528740255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTWANIQUE WALKER Administrator 666-662-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |