| NPI | 1053842815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA SHEPHERD Director 409-365-4798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 311Z00000X Custodial Care Facility | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |