| NPI | 1083865141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKKILYNN PREVOST Co Owner/Director 972-347-6035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |