| NPI | 1629743190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI AL-BADRY Chief Executive Officer 531-220-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |