| NPI | 1033434790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM AIGUOS OMOROGBE Lnfa 817-501-5459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2010-04-10 |