| NPI | 1174012900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA DICKENS Owner 281-438-8166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Additional Taxonomies | 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2018-05-07 |