| NPI | 1790300705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETELEHEM BELAYNEH Director 793-915-3328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2025-11-07 |