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A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
320900000X |
| NPI # | 1295907921 |
| LBN Legal business name | COMMUNITY RESIDENTIAL SUPPORTIVE LIVING |
| Authorized official | MONICA GILLESPIE - (DIRECT SUPPORT PROFESSIONAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/02/2008 |
| Last updated | 04/02/2008 - About 18 years ago |
| Identifiers | n/a |
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COMMUNITY RESIDENTIAL SUPPORTIVE LIVING
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