| NPI | 1043617624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNELL FERNANDEZ CEO 832-468-9311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251X00000X Supports Brokerage |
| Additional Taxonomies | 311Z00000X Custodial Care Facility |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2014-11-26 |
| Last Update Date | 2014-11-26 |