| NPI | 1942005798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELCY ISHIMWE CEO 857-346-3798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |