NPI | 1679802458 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN STUPAK President 267-419-8913 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
Enumeration Date | 2009-12-08 |
Last Update Date | 2009-12-08 |