| NPI | 1154948859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRISHETTE KING Owner 512-876-6043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |