| NPI | 1023138062 |
|---|---|
| Other Name | HTX NORTHWEST VILLA |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY TYLER WHOBREY Provider Enrollment 502-630-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2019-05-28 |