| NPI | 1194313163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBBONY WILKINS CEO 210-325-4964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2022-12-05 |