| NPI | 1760201719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA OMOKHUALE MARUGHU Executive Director 267-694-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |