| NPI | 1992547533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AERIAL ROSS Founder/CEO 217-974-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 177F00000X Lodging |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 282E00000X | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-07-21 |