| NPI | 1174914212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCELYN BAGBY Director 682-888-8417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |