| NPI | 1861067902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRUDENCIA DEBA C.E.O. 346-400-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |