| NPI | 1629842935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRRAH COMIA Owner 725-300-2589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-08 |
| Last Update Date | 2023-11-08 |