| NPI | 1619212313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA FORDEN CEO 917-405-9363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2014-03-06 |