| NPI | 1043526502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M. MATSON President 817-709-6821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2010-08-23 |