A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 320900000X |
* Indicates primary specialty
| NPI Number | 1376738781 |
| Legal business name LBN |
MENTAL RETARDATION WAVIER PROGRAM |
| Authorized official | PERRY ALEXANDER - (CEO) |
| Entity | Organization |
| Organization subpart | No |
| Enumeration date | 09/10/2007 |
| Last updated | 09/13/2007 - About 19 years ago |
| Sole proprietor1 | Not specified |
| Identifiers | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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