| NPI | 1831953108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE ANNAN Director/Owner 929-602-7727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |