| NPI | 1922150200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY SNYDER CFO 330-840-6851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-10-12 |