| NPI | 1215378252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN STERN Traniee 469-235-2941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X (Licence: TX 21147879) |
| Enumeration Date | 2013-07-06 |
| Last Update Date | 2013-07-06 |