| NPI | 1780844027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIBONGINKOSI OSEI Owner 269-806-5459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MI AS390272314) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |