| NPI | 1144558222 |
|---|---|
| Doing Business As | LATONIA DAVIDSON |
| Entity Type | Organization |
| Authorized Contact | LATONIA TAMARA DAVIDSON Program Director 512-809-9576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |