| NPI | 1891558672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM UDOKAH Owner 346-582-8336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 311Z00000X Custodial Care Facility | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-10-07 |