| NPI | 1588840508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNMARIE BUCKINGHAM Compliance Supervisor 234-200-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 171WV0202X Contractor, Vehicle Modifications |
| 253Z00000X In Home Supportive Care | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2023-11-03 |