| NPI | 1871460295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENAVIA KEARNEY CEO/Owner 424-768-3074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-10-21 |
| Last Update Date | 2025-10-21 |