| NPI | 1790588572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUGUETTE BAI CHANTAL GANLONON COOVI Owner 402-502-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |