| NPI | 1023499290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA MENARD Owner 832-884-1527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Additional Taxonomies | 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2015-06-14 |
| Last Update Date | 2015-06-14 |