| NPI | 1245500560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER AGBORTOKO Program Manager 832-681-6909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |