| NPI | 1033959879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANEE S HARBERR CEO 682-521-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-30 |