| NPI | 1609349430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERVONIA ROBINSION CEO 984-221-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |