| NPI | 1588482715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY GILMORE Owner 346-380-3271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |