| NPI | 1114769130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANDRA JOHNSON-EGESI Program Manager 832-785-4089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 163WA2000X Registered Nurse, Administrator | |
| 171M00000X Case Manager/Care Coordinator | |
| 364SL0600X Clinical Nurse Specialist, Long-Term Care | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-19 |