| NPI | 1780356022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLYNN WILLIAMS Administrator 567-316-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2024-03-26 |