| NPI | 1538019955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAR-QUETTA BODDIE CEO/Doo 330-786-6527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-02-03 |
| Last Update Date | 2026-02-03 |