| NPI | 1073913034 |
|---|---|
| Doing Business As | PORTER HOUSE |
| Entity Type | Organization |
| Authorized Contact | TRACEY MINTHREE CUNNINGHAM Owner/ Program Manager 325-518-6052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-09-24 |