| NPI | 1144323502 |
|---|---|
| Other Name | WAGON CROSSING |
| Entity Type | Organization |
| Authorized Contact | DENNIS R LATIMER CEO 512-916-1632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: TX 3647) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |