| NPI | 1801658570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL HENDEROSN Owner 626-468-1482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-03-31 |