| NPI | 1881136505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABY OOMMEN President/CEO 862-221-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2016-11-11 |