| NPI | 1952178360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMICA L WINSTON Doo 567-868-1604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2023-12-06 |
| Last Update Date | 2023-12-06 |