| NPI | 1194500108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA BRADSHAW Professional Level Service Provider 281-645-4490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |