| NPI | 1811666985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN GILBERT MEZA CEO 808-640-2106 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2021-09-10 |
| Last Update Date | 2021-09-10 |