| NPI | 1982492401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKOSUA AGYEIBEA NYAKO Owner 336-268-7405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-04-25 |
| Last Update Date | 2025-10-07 |