| NPI | 1932645108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA BUSCH Payer Contract Specialist 445-206-3028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2021-11-05 |