| NPI | 1801056395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER TYRONE TATUM Counselor 451-845-5073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: CA 101y00000x) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |