| NPI | 1063270023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER GIST CEO 469-430-6557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X Community/Behavioral Health | |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-05-28 |