| NPI | 1104041607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MCMAHAN Regional Program Director 210-647-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded (Licence: TX 117037) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-12-11 |