| NPI | 1003186834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELVERK E WOODS Owner/Cno 972-322-4641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2016-01-06 |