| NPI | 1154087583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY SUE DENNIS Owner 731-609-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 3104A0625X Assisted Living Facility Assisted Living, Mental Illness |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-10 |