| NPI | 1043733231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE LANEA GROVE Program Manager/CEO 817-962-9526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-08-03 |