| NPI | 1699196766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE REESE Certified Nurse 980-428-2473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2013-12-17 |