| NPI | 1174250948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNEDY MADE AMBANI Program Manager 281-854-4074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-08-02 |