| NPI | 1831974146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HALEEMAH GODFREY Owner/Incorporator 862-888-1424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251C00000X |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |