| NPI | 1134630783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY RENE LEWIS Administrative Director 832-894-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2017-10-22 |
| Last Update Date | 2017-10-22 |