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A facility or distinct part of a facility that providers short term, residential care to children, diagnosed with complex or profound disabilities as respite for the regular caregivers.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Respite Care, Physical Disabilities, Child |
385HR2065X |
| NPI Number | 1114393527 |
| LBN Legal business name | SUPPORTING PROVIDER SERVICES |
| Authorized official | THERESA BUFORD - (VOCATIONAL REHABILITATION) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/19/2015 |
| Last updated | 08/19/2015 - About 11 years ago |
| Identifiers | n/a |
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SUPPORTING PROVIDER SERVICES
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SUPPORTING PROVIDER SERVICES