| NPI | 1558073031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB JORDAN CEO/Owner 304-888-9430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 252Y00000X Early Intervention Provider Agency | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care | |
| 385H00000X Respite Care | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2022-12-16 |