| NPI | 1053743856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ANDERSON Contract Manager 409-797-1468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TX 134987) |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| 261QR0401X Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2019-12-09 |