| NPI | 1548990831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKEILA LEMEISHA DRYE Owner 980-622-1061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251B00000X Case Management |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2023-10-05 |