| NPI | 1780440297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD MAURICE JONES Executive Director 848-205-5732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2024-02-22 |
| Last Update Date | 2024-05-01 |