| NPI | 1871317180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GLENN KELLEY CEO 844-936-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2024-11-13 |