| NPI | 1205438116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE ABRAHAM Program Manager 832-638-1954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-11-15 |
| Last Update Date | 2025-03-26 |