| NPI | 1831643121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE TERESE STEWART CEO 872-256-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2016-08-04 |