| NPI | 1194985051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITA NAKEYA ROSE Owner 210-781-3215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-06-13 |