| NPI | 1205473436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGETTE BERRY Program Manager 214-403-0685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 253J00000X Foster Care Agency | |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2020-08-01 |