| NPI | 1013317106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE BAYEMAKE MAHOP Program Director 817-704-9973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-08-26 |
| Last Update Date | 2014-08-26 |