| NPI | 1659987931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA LAMONT PRIMAS Director 478-551-4864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |