| NPI | 1629742135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSELLE BURNETT Managing Member 346-315-7327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2021-08-06 |