| NPI | 1679306567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA KEY Chief Executive Officer 980-248-7854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-09-23 |