| NPI | 1568150696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MMATSEKE META AMELIA JESSICA MAMPANA Director/Owner 347-741-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |