| NPI | 1235960105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORYA KOQUESE JACKSON CEO 972-217-4612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-08-12 |
| Last Update Date | 2024-10-02 |