NPI | 1801628086 |
---|---|
Entity Type | Organization |
Authorized Contact | YASHIRA MARIE MARRERO-SMITH Owner 251-458-3904 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2024-08-16 |
Last Update Date | 2024-08-16 |