| NPI | 1811370521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORTEZ L JONES CEO 330-814-8569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 343900000X Non-emergency Medical Transport (VAN) |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |