| NPI | 1023557840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI M MARTIN-MOORE Administrator 214-778-7228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2021-12-03 |