| NPI | 1134760002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ENGELKE President 512-916-1632 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Mentally Retarded |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-12-23 |