NPI | 1790094241 |
---|---|
Doing Business As | THE SECRET PLACE |
Entity Type | Organization |
Authorized Contact | CHAUNCY DENETTE MONTGOMERY Owner/Director 912-347-2399 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 385H00000X Respite Care |
Enumeration Date | 2010-10-01 |
Last Update Date | 2010-10-01 |