| NPI | 1083298996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA GRANT Program Director 469-685-3470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2021-05-13 |