| NPI | 1205444015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FE LIZA R BENCOSME Program Director 713-377-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |