| NPI | 1760174585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK CHARLES Manager 267-981-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-05-22 |