| NPI | 1568302172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BEAUMONT HUDSON MASQUITTA Administrator 980-457-8839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-03-31 |
| Last Update Date | 2026-03-31 |