| NPI | 1528934163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE L WOODRUFF Owner/Administrator 937-414-9516 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251B00000X Case Management | |
| 253Z00000X In Home Supportive Care | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |