| NPI | 1194854216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS M SMITH Program Manager 972-205-9810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: TX 001007109) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |