| NPI | 1578025383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATIELA STUCKES CEO 980-355-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-11-13 |