| NPI | 1144050436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA ALYSIA LOPEZ Manager 832-574-8497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-08-02 |