| NPI | 1891513495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIOVANNI CHIMA COO 774-297-4013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| 310400000X Assisted Living Facility | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |