| NPI | 1225416746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT SYAINGA SIBANYAMA Program Manager / Owner 817-323-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: TX 0802205266) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: TX 0802205266) |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2015-05-16 |