| NPI | 1124282231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA R MOCTAR Manager 817-719-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) (Licence: TX 124051) |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 124051) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: TX 124051) | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 124051) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |