| NPI | 1831696665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA TODD Operations Business Manager 800-299-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2021-05-03 |