| NPI | 1598579419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDA JOHNSON CEO 531-233-7715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-02-03 |
| Last Update Date | 2025-02-03 |