| NPI | 1790628352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHIEU MUTANDA MATANDA Owner/Director 267-904-0867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-04-09 |
| Last Update Date | 2026-04-09 |