| NPI | 1780165951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL OKEMBA OKELLO Member 901-606-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |