| NPI | 1154719664 |
|---|---|
| Other Name | 4 CORNERS RESIDENTIAL SERVICES, LLC |
| Entity Type | Organization |
| Authorized Contact | RODERIC HORTON Owner 972-897-0548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 343900000X Non-emergency Medical Transport (VAN) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-05-20 |