| NPI | 1689475105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA GRAHAM- BULLOCK Owner 818-818-1817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-03-20 |
| Last Update Date | 2025-03-20 |