| NPI | 1154804128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RAUL SANTOS Program Manager 972-768-5807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2018-09-14 |