| NPI | 1841016144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO LAMONT LOVE Executive Director 618-550-6090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-05 |