| NPI | 1063038214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WONEDWOSSEN GOSHU Director 832-524-4975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2021-10-20 |