| NPI | 1851117063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURTASHA WALLER Owner/Program Director 276-806-9615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-05-19 |