| NPI | 1225450141 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | SYLVIA R. KEPRTA Administrator 817-704-8018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2014-01-11 |
| Last Update Date | 2014-01-11 |