| NPI | 1720968522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALONIKA ROCHELLE COLLIER Member 346-573-6787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |