| NPI | 1194104752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANESHA LAUREN SCOTT Lvn 817-228-5438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: TX 226234) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-05-28 |