| NPI | 1588374763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH STARKS Business Analyst 260-744-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 251C00000X | |
| Enumeration Date | 2022-11-29 |
| Last Update Date | 2023-07-17 |