| NPI | 1760904338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKA LETOINDIA BETTON Executive Director 251-367-8634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 385H00000X Respite Care | |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2022-07-21 |