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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 Number | 1407745243 |
| LBN Legal business name | PROVIDER LLC |
| Authorized official | DELANAM GBEGNON - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 06/28/2025 |
| Last updated | 06/28/2025 - About 11 months ago |
| Identifiers | n/a |
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PROVIDER LLC
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PROVIDER LLC