| NPI | 1043782238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGES NKE Manager/Owner 940-390-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2019-03-11 |