| NPI | 1922834100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE FAYE DRAUGHN-LIGHTNER Qp And Instuctor 888-340-5305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-12 |