NPI | 1831828383 |
---|---|
Entity Type | Organization |
Authorized Contact | JADA MAHOGANY WIGGINS Owner 413-222-3267 |
Organization Subpart ? | No |
Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2022-06-09 |
Last Update Date | 2022-08-04 |