| NPI | 1780844076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA WINFIELD Revenue Cycle Manager 048-807-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2025-03-14 |