| NPI | 1710638648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | O'NEIL WALKER CEO 980-613-5304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 177F00000X Lodging |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2023-07-31 |