| NPI | 1871236059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERIC BROWN Administrator 877-368-0889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2022-04-15 |