| NPI | 1730358060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDALL O PERRYMAN Service Coordinator |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |