| NPI | 1760256887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA DARCEL COLLIER Owner 330-915-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |