| NPI | 1730938606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY OGUCHE C.E.O. 346-762-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2024-05-14 |