| NPI | 1104220136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KWARTENG Owner 214-458-8173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |