| NPI | 1811704778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA CROWE Operator 216-868-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 310500000X Intermediate Care Facility, Mental Illness | |
| Enumeration Date | 2024-12-13 |
| Last Update Date | 2024-12-14 |