| NPI | 1114123015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONDRA DENISE ASKEW Administrator 469-877-8557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 030258) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-08-28 |