| NPI | 1972287589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUALLA D BOLER Doo 330-880-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-06-14 |