| NPI | 1568793362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN STUPAK President 267-419-8913 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2010-01-19 |