| NPI | 1942734702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATUMATA MASSALEE-JALLAH President 347-387-8024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2024-08-19 |