NPI | 1215604863 |
---|---|
Entity Type | Organization |
Authorized Contact | QUEEN AGBONIFO Program Manager 972-375-3354 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2021-08-23 |
Last Update Date | 2021-08-23 |