| NPI | 1811529571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANISHA POLUMBUS Owner 720-300-7719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 376J00000X Homemaker |
| Additional Taxonomies | 251C00000X |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2021-01-25 |