| NPI | 1962131425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMEL S CARTER CEO 917-519-8362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2022-06-08 |
| Last Update Date | 2023-04-03 |