| NPI | 1114386778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONTA J JACKSON Owner 832-490-8067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2016-02-16 |