| NPI | 1659176774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WILSON Admin 862-212-9980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 385H00000X Respite Care | |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-02-13 |