| NPI | 1821861188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINA EVERIST MFUGALE Program Manager 346-498-4876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |