| NPI | 1023678943 |
|---|---|
| Doing Business As | HOUSE OF MARY LOU |
| Entity Type | Organization |
| Authorized Contact | KEONTAQUE ABRON Director Personal Care Coordinator 214-264-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 174200000X Meals |
| 177F00000X Lodging | |
| 251F00000X Home Infusion | |
| 251T00000X PACE Provider Organization | |
| 251V00000X Voluntary or Charitable | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |