| NPI | 1144104688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALINE WAHOME Manager 214-223-0391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2025-08-05 |
| Last Update Date | 2025-08-05 |