| NPI | 1902664683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLEY KABAMBA Director Of Operations 857-333-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251E00000X Home Health |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-03-07 |