| NPI | 1699349464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLATUNDE DAMOLEKUN Program Manager 346-383-7241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |