| NPI | 1043834773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASOH MBEH MABO Program Director 210-427-0509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-10-27 |